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WASHINGTON — The Pharmaceutical Care Management Association (PCMA) released the following statement today ahead of JC Scott, president and CEO of PCMA, testifying before the U.S. House Education and the Workforce Committee Subcommittee on Health, Employment, Labor, and Pensions:
“PCMA applauds the subcommittee’s focus on competition in health care. Pharmacy benefit companies operate in a diverse and growing marketplace. In fact, six new PBMs have entered the market since 2021, bringing the total to 73 full-service pharmacy benefit companies in the U.S. – creating a varied and competitive market.
“Employers, unions, and governments are not obligated to hire a pharmacy benefit company. Yet, virtually all of these health plan sponsors choose to work with pharmacy benefit companies because it brings them significant savings and enables them to better serve the patients in their plans.
“Specifically, employers, unions, and governments choose a PBM as a result of a rigorous RFP process where they, as health plan sponsors, choose a pharmacy benefit company that will best implement their plan designs, control costs, and provide patients affordable access to medications. This is a highly competitive market where pharmacy benefit companies must create value for their clients or be replaced by a company that can.
“Recently, business groups and individual employers from across the country sent a letter to Congress expressing support for preserving employers’ ability to make choices when it comes to contracting. Several anti-PBM policy proposals in the House and Senate look to weaken the contracting flexibility that employers value from pharmacy benefit companies and would also undermine the ability of employers and plan sponsors to contract and design pharmacy benefits for the patients they represent.
Letter to Congress: Business Groups and Employers Express Support for Preserving Their Contracting Flexibility
“Beyond the decision as to which pharmacy benefit company to work with and choices around benefit design, health plans, including employers, also choose how best to use the savings achieved by PBMs. Health plans typically use the savings to lower premiums, lower costs at the pharmacy counter, or increase overall benefits. To be clear, the pharmacy benefit companies deliver savings, and the employer decides how best to implement them.
“In addition, employers determine the information, transparency, and audit rights to be included in their contracts with pharmacy benefit companies. Pharmacy benefit companies are strong proponents of transparency and proactively provide information and data that patients, employers, and policymakers need to make informed decisions about prescription drug products, coverage, and costs. Through transparency measures, pharmacy benefit companies empower patients to shop for coverage that best fits their health needs and budgets.
“We urge the subcommittee and Congress to not lose sight of the anti-competitive practices utilized by drug companies and the increasingly high list prices drug companies routinely set. Pharmacy benefit companies are the only check against drug companies’ otherwise unlimited pricing power, lowering prescription drug costs for more than 275 million Americans through negotiations with drug companies and saving patients, plan sponsors, and taxpayers $1,040 annually.
“It’s time to hold drug companies accountable for exploiting their pricing power. Pharmacy benefit companies call on Congress to avoid misguided legislation that targets pharmacy benefit companies, which plan sponsors, including employers, and hundreds of millions of Americans rely on to make prescription drugs more affordable and accessible.”
